Increased detection of epithelial cell abnormalities by liquid-based gynecologic cytology preparations. A review of accumulated data.
OBJECTIVE
To review published and other available data comparing the effectiveness of liquid-based cytology preparations in detecting epithelial cell abnormalities in cervicovaginal (gynecologic) cytology as compared to the conventional Papanicolaou test.


METHODS
Available split-sample data comparing liquid-based gynecologic cytology preparations with the conventional cervical cytologic test were collated from published studies, unpublished studies reported on at professional meetings or in the press, and from Food and Drug Administration Premarket Clinical Trials on ThinPrep and AutoCyte PREP. Data were stratified with regard to use of newer preparatory instrument models, use of varying collection devices and different split-sample protocols.


RESULTS
Available data from split-sample studies of liquid-based methods showed overall increased detection of epithelial cell abnormalities. Results have varied considerably from study to study and appear to be influenced by collection protocol methods and probably by collection devices' different delivery of cellular material in split-sample studies, first to the conventional smear and second to the liquid-based medium. Newer preparatory instrument models may also enhance detection.


CONCLUSIONS
Liquid-based gynecologic cytology preparations increase detection of epithelial cell abnormalities, as compared to the conventional, single-slide cervical cytologic smear, based on available data from split-sample studies. The true potential impact of these methods in enhancing detection of epithelial cell abnormalities awaits accumulation of data from direct-to-vial studies, especially data on detection of biopsy-confirmed high grade squamous intraepithelial lesions from a wide variety-of clinical practice settings.
Austin
R M
RM
Department of Pathology, Roper Hospital, Charleston, South Carolina 29401, USA.
Ramzy
I
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D001331:Automation; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000517:prevention & control; D002499:Centrifugation, Density Gradient; D002584:Cervix Uteri / Q000473:pathology*; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D004847:Epithelial Cells / Q000473:pathology*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods; D008853:Microscopy; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000295:instrumentation / Q000379:methods; D002577:Uterine Cervical Diseases / Q000175:diagnosis / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000517:prevention & control; D014626:Vaginal Smears / Q000295:instrumentation / Q000379:methods*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology